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. 2025 Jan 14;17(2):259.
doi: 10.3390/cancers17020259.

Prevention and Treatment of Venous Thromboembolism Associated with Amivantamab-Based Therapies in Patients with Lung Cancer-Provisional Clinical Opinion Based on Existing Clinical Practice Guidelines

Florian Moik  1   2 , Gudrun Absenger  1 , Robert Wurm  3 , Maximilian J Hochmair  4 , Cihan Ay  2
Affiliations

Prevention and Treatment of Venous Thromboembolism Associated with Amivantamab-Based Therapies in Patients with Lung Cancer-Provisional Clinical Opinion Based on Existing Clinical Practice Guidelines

Florian Moik et al. Cancers (Basel). .

Abstract

Improved efficacy has been shown for amivantamab and amivantamab-based combination therapies in patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) compared to established treatment options in clinical trials. However, a high risk of venous thromboembolism (VTE) was observed in patients treated with amivantamab-based therapies, with considerable differences in VTE risk according to the line of systemic treatment, concomitant treatment with lazertinib, and intravenous vs. subcutaneous amivantamab administration. Based on early reports of high VTE rates, prophylactic anticoagulation has been implemented in ongoing clinical trials for the first 4 months of amivantamab-lazertinib therapy. However, open questions remain concerning the type, dosing, and duration of primary pharmacological thromboprophylaxis in patients treated with amivantamab-based therapies. Therefore, the aim of this clinical opinion piece is to provide provisional guidance on how to mitigate VTE risk in patients treated with amivantamab-based therapies following existing clinical practice guidelines on primary thromboprophylaxis and treatment of VTE in ambulatory patients with cancer.

Keywords: amivantamab; cancer; lazertinib; lung cancer; thrombosis; venous thromboembolism.

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Conflict of interest statement

F.M. has received travel/congress support from Novartis and Bayer, honoraria for lectures from Servier and Bristol-Myers Squibb, honoraria for consulting from Johnson & Johnson, and participated in advisory boards for MSD, Merck, and Servier. G.A. reports personal fees for lectures, consultancy, and participation in advisory boards from Amgen, AstraZeneca, Bristol Myers Squibb, J&J, Merck, Lilly Oncology, Roche, MSD, Pfizer, and Takeda Oncology. R.W. reports personal fees for lectures, consultancy, and participation in advisory boards from Amgen, Astra Zeneca, Beigene, BMS, Daiichi Sankyo, Eli Lilly, Janssen, J&J, Merck, Novartis, MSD, Pfizer, Pierre Fabre, Roche, Sanofi, and Takeda. M.J.H. reports personal fees for lectures, consultancy, and participation in advisory boards from Amgen, AstraZeneca, Bristol Myers Squibb, J&J, Merck, Lilly Oncology, Roche, MSD, Pfizer, and Takeda Oncology. C.A. has received personal fees for lectures and/or participation in advisory boards from Bayer, Daiichi Sankyo, BMS/Pfizer Alliance, and Sanofi.

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